Three-dimensional indirect ophthalmoscope

ABSTRACT

This invention relates to the combination of two economically simplified systems adjustably supported together for coarse and fine adjustments on a headband worn by an examiner, such as a physician wherein the first system is an optical light concentrator system including a head-mounted housing with an adjustable light source and aligned condenser lens means longitudinally adjustable therein, said system including a light reflector exterior of the housing below said condenser lens means, which exterior reflector may be angularly adjustable by the examiner by remote control means to suitably reflect the condensed light rays of the light source to an objective spot on the target area of a subject to be examined, such as the retina of the eye of the subject, and the second system of the combination consists of an observing optical system for the examiner including binoculars with a pair of occular means adjustable to suitable optical position for the examiner&#39;&#39;s vision to cooperate with an arrangement of reflector members in the binocular housing, whereby the retinal area of the eye or the like of the subject being observed is made luminously visible to the examiner with the binoculars of the observing optical system and wherein said light reflector of the optical light concentrator system may be remotely adjustable by the examiner as the subject is observed to provide for directional positioning of the light spot while the combined systems are supported together on the examiner&#39;&#39;s head.

United States Patent [72] Inventors David N. Cohen 376 A School St.;Brent W. Lambert, 32 Lloyd Road, both of Watertown, Mass. 02172 [21Appl. No. 824,603

[22] Filed May 14, 1969 [45] Patented June 1, 1971 [54]THREE-DIMENSIONAL INDIRECT OTHER REFERENCES Amer. .1. Ophthalmology,Vol. 61, #4, page 16, April 1966 (351 6) Advertisement Keeler OpticalProducts, lnc.

Amer. .1. Ophthalmology, Vol. 45, #1, page XXIV, Jan. 1958 (350- 146)Advertisement American Optical Co.

Primary Examiner-David Schonberg Assistant ExaminerPaul A. SacherpasAttorney-James T. Martin, Esq.

ABSTRACT: This invention relates to the combination of two economicallysimplified systems adjustably supported together for coarse and fineadjustments on a headband worn by an examiner, such as a physicianwherein the first system is an optical light concentrator systemincluding a headmounted housing with an adjustable light source andaligned condenser lens means longitudinally adjustable therein, saidsystem including a light reflector exterior of the housing below saidcondenser lens means, which exterior reflector may be angularlyadjustable by the examiner by remote control means I to suitably reflectthe condensed light rays of the light source to an objective spot on thetarget area of a subject to be examined, such as the retina of the eyeof the subject, and the second system of the combination consists of anobserving optical system for the examiner including binoculars with apair of occular means adjustable to suitable optical position for theexaminer's vision to cooperate with an arrangement of reflector membersin the binocular housing, whereby the retinal area of the eye or thelike of the subject being observed is made luminously visible to theexaminer with the binoculars of the observing optical system and whereinsaid light reflector of the optical light concentrator system may beremotely adjustable by the examiner as the subject is observed toprovide for directional positioning of the light spot while the combinedsystems are supported together on the examiners head.

PATENTED JUN 1 197i SHEET 2 0F 3 THREE-DIMENSIONAL INDIRECTOPHTHALMOSCOPE The present invention relates generally to opticalsurgical instruments and, more particularly, to head-supported opticalsystems used together by physicians to examine the retina of the eye ofa subject.

Instruments of this general class have been more cumbersome and lessefficient in use, because such prior instruments have either been singlehead-mounted light concentrator optical systems uncoordinated with anexamining physician s optical binocular system, such as the De Zeng U.S.Pat. No. 963,036, issued July 5, 1910, or when the attempt was latermade to provide combined systems of optical light concentration with aprojection of the condensed light rays in a spot of light to a targetarea on a patient or subject, the second system comprising themagnifying optical binocular means was also uncoordinated, as inThorburn U.S. Pat. No. 2,757,574, issued Aug. 7, 1956.

For example, such prior systems were cumbersome and unsatisfactory asthe examiner or physician having the respective systems mounted on aheadgear was unable to adjust the reflector means to selectivelyposition the concentrated light rays in a collimated spot of light onthe target area of the subject being examined, except by handling thereflector and moving it by hand for such light spot positioning. Thiswas unsatisfactory because the hand of the examiner would soil anddeface the reflector surface to provide undesired aberrations and causeerror in diagnosing an area being examined. Also, when mounted on theexaminers head not only does his hand get in the way of the light raysto be reflected, but also it is clumsy to make such manual adjustmentswhile the examiner is viewing the subjects target area, such as theretina of the eye. I

Accordingly, it is an object of this invention to provide a novel remotecontrol adjusting means for a novelly mounted concentrated light rayreflector system, whereby the optical binocular system adjacent the rayreflector, while being used to observe the subject received light spotarea, may be remotely angularly positioned without ever touching thereflector itself to position the same and project the concentrated lightrays to a target point.

Another object is to provide, in combination, an optical lightconcentrator system and an optical binocular system mounted togetherandsupported on headgear worn by an examining person, said concentratorsystem having an adjustable spring-mounted mirror for projecting aconcentrated ray of light to a target spot on a subject being examinedwith remote manual control means to tilt the mirror to desired angularpositions according to determinations of the examining person wearingthe headgear, to thereby position the concentrated light rays withrespect to the target spot on the subject.

Another object is to provide cooling means for dissipating heat from thelight source of a light concentrator system supported by a headgear wornby an examining physician, to thereby provide for comfort and tofacilitate the use of an optical binocular system likewise supported bythe headgear in conjunction with said light concentrator system.

A more specific object is to provide a novel reciprocal remote controlthrust means with a flexible means, such as a lubricated elongated metalcoil spring, such spring may be Teflon coated, for angular adjustment ofa spring-mounted projection reflector of a concentrated light beam froma headgear supported optical light concentrator system, whereby aresulting spot is positionable on the target area of a subject beingexamined through an adjacentiy mounted optical binocular means.

The foregoing and other objects and advantages of the present inventionwill appear more fully hereinafter from the following detaileddescription, when considered together with the accompanying drawings,wherein the parts in the specification are numbered and referred to bylike numerals throughout the drawings.

It is to be expressly understood that the drawings, herewith, are forthe purposes of illustration only and are not to be construed asdefining the limits of the invention, reference being had for thispurpose to the appended claims.

In the drawings:

FIG. 1 is an assembled perspective view of the present inventionillustrating one embodiment of the binocular indirect ophthalmoscope;

FIG. 2 is a longitudinal cross section view of the invention with a partof the headgear broken away;

FIG. 3 is a transverse section taken along the line 3-3 of FIG. 2;

FIG. 4 is a view partly in sebtion taken on line 44 of FIG. 2 showingthe centrally located window in the front wall of the binocular casing;

FIG. 5 is a cross section view of the remote control means and themountings therefor with the fine adjustment spur lug on the mirror orreflector to direct the concentrated light rays to the subject beingexamined through the optical binocular system;

FIG. 6 is a general diagrammatic view of the optical viewing binocularsystem or imaging system for viewing the point of light projected to thesubjects eye being examined and illustrating use of a hand-held lens tobe held by the examining party before the subject, if desired;

FIG. 7 is a diagrammatic view of the illumination system used with theimaging system showing the concentrated light rays to the patient orsubject and showing a hand-held lens be fore the patient or subjectseye, as desired during examination.

Referring to the drawings, and first with particular reference to FIG.1, there is shown an assembled perspective view of the respectivecomponents of the present invention; namely a headgear 10 with anannular headband 11 to which are universally mounted the twocooperatively connected systems A and B of the invention for respectivecoarse and fine adjustments during use. Knurled heads 8 and 9 areprovided to set and adjust the universal connection on band 11.

The system A comprises an optical light concentrator system formed of anelongated tubular housing 15, with condensing lens means 16 mountedtherein, so as to be axially adjustable longitudinally of the housing,see FIGS. 2 and 3. The housing 15 is open at each respective end 18 and19 with the end 18 formed to receive alight source such as a light bulb21 and electric power socket 22 for holding the bulb in position fordirecting light rays axially through the condensing lens means 16 in thehousing 15 mounted in adjustable sleeve 20 to a suitable lightprojection means at the opposite end of the housing.

The electric power socket 22 is preferably formed with an exteriorannular surface 24 adapted to frictionally engage with the interior boreof the housing 15 and may include annular heat-dissipating fins 25around the upper bulb holder from which an electric connector cord 26leads for connection to a suitable source of electric power. Thus, thebulb holder comprising the bulb and socket are frictionally adjustablein the upper part of housing 15 with respect to the lower mediallypositioned condenser lens means 16 mounted in sleeve 20 therein. Also,an exterior skeleton jacket 23 with heat-dissipating ribs 23a is spacedaround part of the housing 15 and is held in place by fastening means,such as a thumbscrew or the like.

The housing end 19 below the condenser lens means is formed with anangular opening in the provision of the formation of a scoop-shaped end27. The scoop-shaped end 27 is formed to receive a reflector such as amirror 28 and this mirror is mounted in a support plate 29 to which isfastened a flat spring hinge 30 formed of two leaf portions 31 and 32,one leaf portion being secured by screw means 33 to the mirror supportplate 29 and the other leaf portion is engaged with the roof of thebinocular casing after it is folded around the hinge pin mounted betweenbrackets 59 and 60 formed from the front wall 58 of the binocularhousing 42, see FIGS. 1, 2 and 4.

The mirror support plate 29 has an elongated spur lug 36 formedtherefrom which extends like a spur through a vertical slot 35 in thescoop end 27 of the housing 15, see FIGS. 1 and 2. This spur lug 36 isbiased by the spiing hinge 30 into engagement with the thrust pin 37 ofa remote control means 38 for fine adjustments of the light raysprojector mirror 28 said control means being remotely operable by anexaminer, such as a physician or nurse. This remote control means ishereinafter described in connection with the optical observing orviewing system The optical observing or viewing system B comprises apair of binoculars with spaced iateral adjustable occular means 39mounted in plates 39A and 39B slidable to position with respect to theeyes of the examiner. The binocular housing generally referenced bynumeral 42 is shaped and formed interiorly so as to position and mount astereoscopic optical mirror system comprised of mirrors 43, 44, 45 and46, see FIG. 6, whereby when viewing an objective or target spot on anarea such as the retina of a subejcts eye, the same will appearmagnified with a three-dimensional effect.

The binocular housing 42 is supported by the band 11 of the headgear bya universal joint 41 and a bracket 47, see FIG. 2; and, because of theuniversal mounting. Further, due to the fact that the elongated lamphousing is secured by threaded fasteners, such as bolts 48 and 49 to thefront of the bracket 47 on each side of the vertical slot 35 of housing20, which mates or straddles the spur lug 36, the units of eachrespective system are thus secured together to permit manual movement ofthe binoculars 42 on the headband universal mounting also to permitmovement of the lamp housing 15 for a coarse adjustment of therespective systems at the start of the eye examination of a subject. Forexample, see the diagrammatic views in FIGS. 6 and 7 showing field lensmeans in the provision of an indirect ophthalmoscope.

After the starting coarse adjustment of the two optical systems A and B,during the examination ofa subjects eye, it usually is necessary to makefine adjustments of the projected concentrate or focus of light rays andthe resulting light spot, so as to position the projected concentratedpoint of light in a spot on the retina in relatively fine elevationalincrements. This is accomplished by the novel remote control means 38,hereinbefore referred to, engaged at one end with the spur lug 36extending from the mirror support by the thrust pin 37 of the controlmeans.

The remote control means 38 comprises a suitably curved guide tube 50which may be formed of metal or Teflon because of the natural lubricanteffects of the latter material and which is mounted at the lowerscoop'shaped end 27 of the lamp housing 15. The bore of the tube 50encloses a reciprocatable elongated flexible means, such as aTefloncoated coil spring or a metal spring 51 coated with suitablelubricant. This spring 51 is of a length short of the open ends of theguide tube 50 and each respective end of the spring may be in abuttingcontact with an enclosed end of each of the respective thrust pins 37and 52. Or, in some instances, such oppose-d ends of the spring 51 andthe respective aligned ends of the thrust -pins may include Teflonspacer means S for promoting operating efficiency, see FIG. 5. Thrustpin 37 has an end projecting beyond the end of the tube 50 adjacent thespur lug 36 in engagement therewith and thrust pin 52 has an endprojecting beyond the opposite end of the suitably curved tube 50inengagement with the bore ofa socket nut 53 with a knurled adjustmenthead 54 and an outer threaded bore portion 55 in a suitable matingthreaded shank 56 on the tube 5=, see FIG. 4.

When the knurled head 54 is turned the thrust pin 52 is moved andimparts reciprocation to the flexible means, such as the coated springor the like 51, in the guide tube 50 and thence to move the thrust pin37 in contact with the spur lug 36 carried by mirror 28. This causes thereflect-or to pivot on the leaf spring hinge 30 supporting the reflectoror mirror 28, to thereby provide for fine angular adjustments toposition the reflected concentrated light beams in a spot of light atdesired elevational positions over an area being examined during theexamination of the subject.

The binocular casing 42 includes a front wall 58 with an opening definedby hinge pin brackets 59 and 60 and with a window 61 centrally locatedtherein and recessed inwardly of the brackets. Also, centrally of thewindow is positioned the apex point of diverging mirrors 43 and 44positioned to equally reflect from the reflecting surfaces of mirrors 45and 46 to their respective occular members 39. The brackets 59 and 60are formed with sockets to receive the opposed free ends of a hinge pin62 around which the spring hinge 30 is medially folded, see FIG. 6.

Thus, there is provided a novel three-dimensional binocular indirectophthalmoscope combination, wherein the casing of the optical binocularis arranged with mounting means for all the components of the lightconcentrator system.

Without further description it is believed that the novel combination ofelements of the present invention has been sufficientiy described andillustrated, to permit a clear understanding thereof as required underthe patent statutes.

What we claim is:

I. In an indirect ophthalmoscope of the type that includes an opticalsystem comprising a support means, a light source, a mirror, said lightsource mounted on said support rneans, said mirror attached to aflexible meansmounted on said support means and positioned to receiveand reflect light emanating from said light source, the combinationthereof with remote control thrust means operatively adjacent to saidflexible means and mounted on said support means in a manner to providefor selective adjustment of said rnirror by action of said thrust meanson said flexible means to vary the angle of reflection of lightemanating from said light source and reflected by said mirror.

2. In an indirect ophthalmoscope of the type that includes an opticalsystem as described in claim 1, a thrust means that includes a tubularthrust guide, thrust pins, a thrust spring and a manually adjustablethrust means initiator, said thrust pins located at either end of saidtubular thrust guide and separated by said thrust spring, said manuallyadjustable thrust means initlator mounted adjacent one of such pins sothat, by manual adjustment, that initiator means urges one thrust pinagainst said thrust spring that in turn is urged against the otherthrust pin that in turn urges against the flexible means attached tosaid mirror.

3. In an indirect ophthalmoscope of the type that includes an opticalsystem as described in claim 2, a thrust spring that is made of amaterial having a relatively low coefficient of friction.

4. In an indirect ophthalmoscope of the type that includes an opticalsystem as described in claim 2, a tubular thrust guide whose axis iscurved.

5. in an indirect ophthalmoscope of the type that includes an opticalsystem as described in claim 1, a flexible means mounted on said supportmeans and attached to said mirror that comprises a spring means.

6. In an indirect ophthalmoscope of the type that includes an opticalsystem as described in claim 2, a flexible means mounted on said supportmeans and attached to said mirror that comprises a spring means.

1. In an indirect ophthalmoscope of the type that includes an opticalsystem comprising a support means, a light source, a mirror, said lightSource mounted on said support means, said mirror attached to a flexiblemeans mounted on said support means and positioned to receive andreflect light emanating from said light source, the combination thereofwith remote control thrust means operatively adjacent to said flexiblemeans and mounted on said support means in a manner to provide forselective adjustment of said mirror by action of said thrust means onsaid flexible means to vary the angle of reflection of light emanatingfrom said light source and reflected by said mirror.
 2. In an indirectophthalmoscope of the type that includes an optical system as describedin claim 1, a thrust means that includes a tubular thrust guide, thrustpins, a thrust spring and a manually adjustable thrust means initiator,said thrust pins located at either end of said tubular thrust guide andseparated by said thrust spring, said manually adjustable thrust meansinitiator mounted adjacent one of such pins so that, by manualadjustment, that initiator means urges one thrust pin against saidthrust spring that in turn is urged against the other thrust pin that inturn urges against the flexible means attached to said mirror.
 3. In anindirect ophthalmoscope of the type that includes an optical system asdescribed in claim 2, a thrust spring that is made of a material havinga relatively low coefficient of friction.
 4. In an indirectophthalmoscope of the type that includes an optical system as describedin claim 2, a tubular thrust guide whose axis is curved.
 5. In anindirect ophthalmoscope of the type that includes an optical system asdescribed in claim 1, a flexible means mounted on said support means andattached to said mirror that comprises a spring means.
 6. In an indirectophthalmoscope of the type that includes an optical system as describedin claim 2, a flexible means mounted on said support means and attachedto said mirror that comprises a spring means.